Z40.89
Z40.89: Encounter for other prophylactic surgery
Billable / specific codeICD-10-CMPOA exempt
Z40.89 is a billable, specific ICD-10-CM code for encounter for other prophylactic surgery. It is valid for submission on a claim.
Check Z40.89 with the rest of the claim: free scrubberOther codes that can never be billed with Z40.89
Their own Excludes1 notes name this code, so the conflict is not listed above.
- Z29Encounter for other prophylactic measures
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
Z40.89 is named in 1 Medicare coverage policy: 0 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A56658Billing and Coding: Cosmetic and Reconstructive Surgerynot covered
Alphabetic index entries that lead here
- Prophylactic›surgery›specified NEC
Code history
- addedFY2024-FY2027
Encounter for other prophylactic surgery